[Factors associated with selection of breast-conserving surgery in early female patients with breast cancer]

Abstract

Objective: To analyse the factors associated with the selection of breast- conserving surgery in early female patients with breast cancer. Methods: The targeted patients were females diagnosed with early-stage breast cancer and received surgical treatment at Fujian Provincial Hospital from January 1, 2015, to December 31, 2019. The targeted patients' clinical, demographic, and social-economic characteristics were extracted from the hospital health information system. Relevant information of their attending surgeons was collected through a smart-phone based self-respond online survey. We performed multivariate logistic regression to explore the associated factors with breast-conserving surgery (BCS) decision-making. Results: The age of the patient and attending surgeon and the economic development level of the patient's residence area were the associated factors with BCS decision-making of female early-stage breast cancer. By controlling the other factors unchanged, patients from middle-income areas were more likely to accept BCS (OR=1.91, 95%CI: 1.01-3.62, P=0.05) than those from low-income areas. When the attending surgeon was at the average age of 45 years old, increasing of 1 year age of patient led to 4% decrease of the probability of BCS (95%CI: -0.07 - -0.01, P=0.01). When the patient was at the average age of 52 years old, increasing of 1 year age of the attending surgeon reduced 10% of the probability of BCS (95%CI: -0.19 - -0.01, P=0.03). The interaction effects related to the age of attending surgeon and patient for some observations to choose BCS were statistically significant, and the average interaction effect was 0.06% (Z=2.11, s_x =0.000 3, P<0.05). Conclusion: To promote breast-conserving surgery in the indicated early female patients with breast cancer, it is necessary to consider factors from both the surgeons and the patients.